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August – September 2010 Issue

Semper Ubi Sub Ubi

readme:

Well, there you go. I’ll bet you’re wondering what I did on my summer vacation. In fact, I’ll bet you’re wondering why I never mentioned that I was taking a summer vacation. I’ll explain after the jump.

First off, thanks to all the folks who expressed condolences on the loss of our kitty Harry. He is sorely missed.

Secondly, we now have a couple of hundred fans on our Facebook page, which is awesome, although I’m still not sure why we have a Facebook page. It was my assistant Edith Freedle’s idea, and she went on an “emergency vacation” right after she set it up. She’s been on vacation for a long time, and her cell phone seems to be busted, but I’ll ask her about it if and when she ever comes back.

I kinda like Slate’s tech columnist, Farhad Manjoo. He’s certainly better than the relentlessly smarmy and ethically-challenged David Pogue at the NYT. But this is a seriously silly article. Nobody needs to have 200 browser tabs open at once. First of all, there is at least one Firefox extension, Tab Mix Plus, that makes it easy to save “sessions” (groups of tabs) so you can reopen all of them later. I do a lot of research online, often involving dozens of tabs, but I don’t leave them open all the time. That’s like trying to wear all the socks you own at once.

Secondly, it’s nice that he built himself a speedy computer, but his biggest problem with performance in his old machine (apart from the tab nonsense) was almost certainly Windows 7 (aka Vista II) itself, most particularly in its need for some kind of resource-hogging anti-virus software. Dude, seriously, I hate Macs personally, but get a Mac for pete’s sake. That anti-virus stuff (especially the bloated Norton, McAfee, etc.) eats more processor speed than most viruses and malware do. Any Mac with similar specs is gonna run faster. And Linux is gonna run much, much faster. The secret about Linux is that it’s a great way to revivify an aging PC. I have an eight-year old Dell cheapo single-core Pentium running Ubuntu that runs snappier than Windows 7 on a brand-new laptop.

Speaking of such things, I’ve been using the latest version of Ubuntu Linux since last spring and I’m very impressed. I’ve been using Linux since I dumped Windows about six years ago, and Ubuntu has finally gotten to the point where I’d be willing to recommend it to just about any PC user. You can try Ubuntu, incidentally, without installing it on your hard drive, and as soon as you reboot your computer it’s gone, leaving no trace on your computer.

There is one part of the current Ubuntu which does not work, however, and that’s the Ubuntu One online backup service. I tried using it on three different computers and it really just isn’t reliable enough to depend on. Having been bitten by the idea of an online backup service that would allow me to painlessly share files between computers, I went looking for alternatives and discovered Dropbox, which differs from Ubuntu One by actually working the way it’s supposed to. Now I can turn on any of my computers and know that I’m looking at the latest version of my columns. Dropbox works on Windows, Mac or Linux, a 2 gigabyte account is free, and if you use this link to sign up, you and I will both get an extra 250 megabytes of storage space for free.

And now, those of you interested in my lame excuses for missing deadlines can follow the link below…

Way back before there were MRIs and CAT scans and lumbar punctures, doctors had an interesting way to diagnose multiple sclerosis: they would take the afflicted person and dump them into a bathtub full of hot water. If the person floated, they were declared a witch and put to work transforming toads into investment bankers. If, however, they merely flopped around on the floor when pulled from the tub and reported that they had lost all feeling in their limbs, they were diagnosed with MS and sent on a charity walk. (Seriously, am I being too cranky when I point out that all these MS walks are in dubious taste on some level? Probably.)

So now fast-forward to this past July, when the thermometer here in Central Aheya hit the mid-90s and pretty much stayed there for the next two months. Badda-bing, all my symptoms went to eleven. Muscle cramps, numbness, muscle cramps with numbness with a side of blinding headaches and blurred vision, topped with the kind of exhaustion normally experienced by people who work a lot harder than I do. The strangest (and most distressing) effect was a new one: my legs, after just a few minutes standing, would stop answering the phone. They might hurt at that moment and/or they might be numb, but eventually they would simply stop working and resist all my orders. It’s a very weird moment when you can see your leg, and sorta feel it, but it refuses to even twitch for you. This is, I can attest, very inconvenient when it happens, as it did one day, when you’re standing in the middle of a crowded bookstore and suddenly literally can’t walk, even with a cane.

Now that the temps have come down a bit things are better, but the weird disconnect in my legs after a few minutes standing seems to be a permanent feature. I also can’t really hold things in my left hand and, when I type, that hand makes scads of typos. It’s been exactly four years this month that they diagnosed me with primary-progressive ms, and I guess this is progress of the sort they meant. All I know is that it is enormously depressing and makes getting anything done a major chore. I would never have suspected how attached to walking across the room I was. Anyway, that’s where the August issue went.

See? Lame excuse. Is joke. You will laugh now.

Incidentally, speaking of lumbar punctures, one last thing. I mentioned a few months ago that I have taken to watching House in reruns. Certain people are apparently driven nuts by my willingness to watch the show out of sequence. I knew, for example, that a certain character’s paramour had died even before I knew said paramour existed. But since the show is supposedly modeled on the Sherlock Holmes mysteries, I like to derive an extra meta-thrill by deducing the backstory of each episode without the crutch of chronological order.

Anyway, lumbar puncture (aka spinal tap) seems to crop up as a diagnostic procedure fairly often on House (and they seem to initially suspect MS in almost every case), but, speaking as a onetime puncturee myself, I find the presentation of the procedure on House a bit deceptive.

In the show, they lay the victim on a table in a vaguely fetal position, swab his or her back with antiseptic, stick a long needle into the spinal column and suck out a bit of fluid. So far, so accurate. But the next scene is almost always a bit later, when they go into the patient’s room to deliver the test verdict. And here’s where reality diverges from House. In House, the room is quiet except for the snarking. In real life, however, the snark would be inaudible, drowned out by the howls of pain coming from the recently tapped patient.

When you have a lumbar puncture, the doctor will tell you that it is very important to lie completely still on the table for an hour or so after the procedure, lest you develop a headache from the test. What they don’t tell you is that the reason you may develop a headache is that they have just essentially drained your oil, lowered the pressure in the cerebrospinal fluid (CSF) surrounding your brain. But the reason they want you to lie there quietly for an hour is not to minimize the chances of you developing a headache. You are absolutely, positively going to develop a headache, the worst headache of your life, a week-long blinding weeping pleading bulletproof lie-on-the-couch-and-scream headache from hell, until the pokey little CSF factory in some remote province of your body tops off your tank again.

Lying very quietly on the table will not prevent this, so you might as well jump right up and go have a slice of pizza while you still can see, think and chew.

The real reason they tell you to lie there for an hour is to give the doctor a chance to get out of the building and halfway home before you start vowing to kill him and burn down his clinic.

I speak from experience, and House owes it to its viewers to depict lumbar puncture and its aftermath a bit more realistically. Let me put it this way: I recently saw an episode from a few years ago where an ex-patient shows up and, with no explanation, shoots House several times with a rather large handgun. And my first thought was “I bet they gave that guy a spinal tap.”

4 comments to August – September 2010 Issue

Au contraire. It’s not that they took the fluid, but because the hole is still open. While the hole they made is still open the fluid will seep out into your tissue when you stand up and this will expose the top of the spinal cord and cause the headache.

If the hole is closed immediately, using blood patch, the headaches stop immediately.

First time the operation was done to me I had to kiss my ass so that they could get the needle in. I have a friend who is anesthesiologist and he suggested that I ask the blood patch. The doctor treating me didn’t like to be told what to do and so she declined, gave me coffein pills and sent me home on friday. Monday morning I went back to the hospital and asked for the blood patch. Instaed of giving it to me immediately they put me on iv coffein solution. When that didn’t work I got the blood patch. The operation is easy. Some blood is drawn from you and injected into the same hole the punction was done. The blood coagulates and closes the hole.

I sued the doctor and was given compensation for unnecessary pain.

After that I’ve had have the operation done three times more and got the blood patch immediately afterwards.

You’re right, of course. I was being a bit facetious. I actually had the procedure done four years ago and had forgotten about the blood patch. The guy who did it, Dr. Rammohan at the OSU MS Clinic (great doc, now retired), had done so many of them that it was over very quickly and didn’t hurt at all. By the time the headache developed, I was at home 50+ miles from the clinic, so returning would have been difficult (and I wouldn’t take a dog to the “hospital” near us). If I ever have it done again, I’ll ask about it right then.

Unsolicited Suggestion: I cannot speak from personal experience, thank Heaven, but once heard a talk by a former MS sufferer whose rather advanced case (with frequent wheelchair days) cleared up when she switched to an all-raw diet. Last I heard, she was teaching aerobics.

If that piques your interest, but you’re not ready to dump your kitchen range, let me point out that just about anybody can benefit from adding a green smoothie to their regular daily diet (for examples, see http://www.rawfamily.com/recipes).

As a recent reader, I didn’t know you had MS; an ex of mine was diagnosed with it while we were involved. There was some new medication which was in the last phase of clinical trials, and apparently it worked wonderfully – it apparently is supposed to stop the symptoms from worsening. The catch is that if you *stop* taking it, then the symptoms progress to where they would have been had you never taken it… so there was a class-action suit (settled out of court) to ensure that the patients who were in the clinical trials whose financial/insurance situation would not allow them to continue to get the medication would have it provided to them.

Don’t remember what the stuff was called off-hand, but I could find out if you’re interested.